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Impact of Vaginal-Rectal Ultrasound Examinations with Covered and Low-Level Disinfected Transducers on Infectious Transmissions in France

Published online by Cambridge University Press:  10 May 2016

Sandrine Leroy ,
Fatima M’Zali ,
Michael Kann ,
David J. Weber  and
David D. Smith
Sandrine Leroy*
Affiliation:
Laboratoire de Biostatistique, Epidémiologie, Santé Publique et Informatique Médicale, Centre Hospitalier Universitaire (CHU) de Nîmes, Nîmes, France; and EA 2415 Unit, Montpellier 1 University, Montpellier, France
Fatima M’Zali
Affiliation:
Université de Bordeaux, Microbiologie Fondamentale et Pathogénicité, Unité de Mixte de Recherche (UMR) 5234, Bordeaux, France; and Centre National de la Recherche Scientifique, Microbiologie Fondamentale et Pathogénicité, UMR 5234, Bordeaux, France
Michael Kann
Affiliation:
Université de Bordeaux, Microbiologie Fondamentale et Pathogénicité, Unité de Mixte de Recherche (UMR) 5234, Bordeaux, France; and Centre National de la Recherche Scientifique, Microbiologie Fondamentale et Pathogénicité, UMR 5234, Bordeaux, France CHU de Bordeaux, Bordeaux, France
David J. Weber
Affiliation:
Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina
David D. Smith
Affiliation:
Department of Biostatistics, City of Hope, Duarte, California
*
EA2415 Unit, Montpellier 1 University, 34295 Montpellier, Cedex 5, France ([email protected]).
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Abstract

Background.

The risk of cross-infection from shared ultrasound probes in endorectal and vaginal ultrasonography due to low-level disinfection (LLD) is difficult to estimate because potential infections are also sexually transmitted diseases, and route of contamination is often difficult to establish. In France, the widely used standard for prevention of infections is through the use of probe covers and LLD of the ultrasound transducer by disinfectant wipes. We performed an in silico simulation based on a systematic review to estimate the number of patients infected after endorectal or vaginal ultrasonography examination using LLD for probes.

Study design.

We performed a stochastic Monte Carlo computer simulation to produce hypothetical cohorts for a population of 4 million annual ultrasound examinations performed in France, and we estimated the number of infected patients for human immunodeficiency virus (HIV), herpes simplex virus, hepatitis B virus, hepatitis C virus, human papilloma virus, cytomegalovirus, and Chlamydia trachomatis. Modeling parameters were estimated by meta-analysis when possible.

Results.

The probability of infection from a contaminated probe ranged from 1% to 6%, depending on the pathogen. For cases of HIV infection, this would result in approximately 60 infected patients per year. For other common viral infections, the number of new cases ranged from 1,600 to 15,000 per year that could be attributable directly to ultrasound and LLD procedures.

Conclusions.

Our simulation results showed that, despite cumulative use of probe cover and LLD, there were still some cases of de novo infection that may be attributable to ultrasound procedures. These cases are preventable by reviewing the currently used LLD and/or upgrading LLD to high-level disinfection, as recommended by the US Centers for Disease Control and Prevention.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 35 , Issue 12 , December 2014 , pp. 1497 - 1504
Copyright
© 2014 by The Society for Healthcare Epidemiology of America. All rights reserved.

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